How Alcohol Might Influence Bone Mass in Adolescent, Adult, and Postmenopausal Women

Age	Attribute or Parameter	Effects of Estrogen	Effects of Estrogen and Alcohol
Adolescent
	Bone Growth	↓	↓
	Bone Density	↑	↔
Young Adult
	Remodeling Rate	↓	↓
	Remodeling Balance	↔	↓
	- Formation	↓	↓
	- Resorption	↓	↓
	Density	↔	↓
		Effects of Estrogen Deficiency	Effects of Alcohol
Postmenopausal
	Remodeling Rate	↑	↔
	Remodeling Balance	↓	↓
	- Formation	↑	↔
	- Resorption	↑	↑
	Density	↓	↓

NOTE: Bone remodeling is the process by which small areas of bone are destroyed and rebuilt. Bone resorption is the first step in bone remodeling, in which a small packet of bone is broken down. Bone formation is the rebuilding process that follows bone resorption. An imbalance in bone remodeling occurs when bone formation does not adequately compensate for bone resorption. Bone loss occurs as a result. Estrogen deficiency accelerates bone remodeling and leads to an imbalance in remodeling. Alcohol might reduce bone loss in postmenopausal women by increasing the circulating levels of estrogen, or by acting on bone cells to reduce bone remodeling. Decreased bone density increases the risk for osteoporosis. Size of arrow represents the magnitude of change.

↑ indicates increase

↓ indicates decrease

↔ indicates no net change